Altrua Health Share

I don’t understand why people are rating this company based on the ease of sign up- OF COURSE that will be a great experience; they want your money! Might want to wait until you ACTUALLY need to use it before giving them a high rating...

If I could give them ZERO stars, I would. Be prepared to not have A CLUE in how much they will ‘share’, if anything, towards medical claims. They also do not have EDUCATED staff to review medical records before making determinations as to what qualifies or breaks their ‘rules’. I was involved in a NO-FAULT accident, shattered my pelvis on both sides, had to be transported to the hospital via ambulance and spent 4 days there. The medical bills were HUGE. They first tried to get me to work with the hospital and get financial relief (I was out of work for the 1st and only time in my life due to Covid and business basically shutting down) so they could get out of sharing anything- The hospital didn’t buy that and said Altrua had to FIRST contribute and whatever was remaining they would work with me on. Fast-forward and they then DENIED ALL CLAIMS, stating ‘excessive alcohol’ use. When you sign up for this membership, and in order to remain eligible for sharing you have to live a healthy lifestyle- No smoking, no excessive alcohol… The medical records team read my blood test wrong! 24ml equates to a .02 BAC. It even said on the test result ‘null / none found’. But they conveniently ignored that, either played stupid or truly werhen’t smart enough to convert it and *decided* that my BAC was .24. After hours and hours of phone calls, 4 appeal letters explaining this…. They FINALLY started sharing. But they screwed me ROYALLY- Because bills went unpaid and to collections, my credit score went from over 800 down to under 700. Over TWO YEAS later and I’m STILL working to get the last item paid and removed from the credit reporting agencies. This last one they submitted as a ‘Workman’s Comp’ claim so they could get a lower negotiated rate (they are responsible for 100% of this bill) and it was rejected because it was obviously filed under false pretenses. Even when this last item is paid and removed from my credit score, it will take YEARS before it goes back up to where it was.

Literally, a nightmare. I’d just assume not have insurance / healthshare coverage at all. Over TWO YEARS dealing with just this, the financial impact, stress… NO THANK YOU. I dumped them and am with Sidecar Health now- Never been happier.

I had EMERGENCY retina attachment surgery while a member of ALTRUA. I had to go to six facilities (E.R. room at Mission Hospital, two different ophthalmologist offices, a surgery center, and there were separate bills from the E.R. Physician, and the Anesthesiologist), and ALTRUA is rejecting all of the invoices, because the invoice doesn't have a diagnosis code, AND a procedure code.

This is how ALTRUA routinely denies claims. They blame the health care member because the itemized statement we receive from medical care providers doesn't have all of the detailed information they require, however, even the Emergency Room itemized statement doesn't contain a diagnosis code! That's not something the hospital includes in their statements. ALTRUA is quite clearly a corrupt organization.

I expected a higher level of caring and service from an organization that claims to be Christian based. Very very disappointed (but not entirely surprised).

03/23/Revdex.comRutherford Lane Ste 100Austin, TX 78754(512) 445-Re: Complaint ID: [redacted] Complainant: [redacted] Attn: [redacted] Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of [redacted] as we would like to resolve this matter promptly and thank you for your patienceI first want to acknowledge Mrs [redacted] ’s frustration in trying to get her medical needs issue resolvedIt is our goal to provide all of our members with the best member service experience possible and through this response I hope she can gain peace of mind and clarity on this matterAccording to our records, Mrs [redacted] ’s case is in pending status with our provider resolution teamHowever, as a courtesy to all of our members and a way to help reduce the cost of their medical needs, Altrua passes along discounts afforded to us by our networkUnfortunately, it is not a guarantee that the provider will accept these discounts and if not our resolutions team steps in to resolve those mattersThus, all of the medical needs Mrs [redacted] references in her complaint is pending to get resolved as promptly as possibleTypically, this process can take anywhere from 30-days depending on the cooperation of all party’s involvedPlease reference Section F, paragraph Working with your Health Care Provider, which states a member will be responsible for 50% of the allowed charges based on the member responsibility amount under their plan type in the event her medical need is eligibleIn conclusion, in order to offer a Mrs [redacted] a resolution we will have to wait on the outcome of this case pending in the resolution dept., however, we will have a representative reach out to her directly to address her concerns regarding this compliant Please advise if this response is sufficient to close out this complaint or contact me directly for further responseWarmest regards, [redacted] EXECUTIVE COMPLIANCE DIRECTOR

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Sir With reference to the above complaintThe matter has now been resolved therefore no action on your part is necessaryKindest regards [redacted]

03/01/2018Revdex.comRutherford Lane Ste 100Austin, TX 78754(512) 445-4748Re: Complaint ID: [redacted] Complainant: [redacted] ATTN: [redacted] Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of [redacted] and thank you for your patience in receiving this responseIt is our responsibility to take all complaints very seriously and it is our every intention to bring resolve to these matters promptly.I first want to acknowledge that we sincerely apologize for any inconvenience Mr [redacted] may have experienced due to billing issuesThus, we value our members experience with Altrua and strive every day to improve the services being provided.As a member of Altrua, it is the member’s responsibility to contact us directly if they are having any issues regarding their membershipThis is outlined in the Members Rights and Responsibilities section of our Membership GuidelinesEvery year Altrua conducts a year end audit for all contributions received on behalf of the membershipThis audit produced a list of members that did not contribute to the membership during specific months based on their individual accountsAs a good faith measure, all members were informed of any contributions that were not received for their particular accountHowever, this notification also included that, if for any reason, our records were incorrect to contact us directly to resolve this issue promptlyAltrua does not contract with agents to offer their memberships nor do we contract with insurance agenciesThus, Altrua is not responsible for the actions of a third party that a member willful chooses to manage their membershipOur records indicate that Mr [redacted] ’s proof of overpayment was not received until 02/05/2018, which did indicate he was billed twice in the month of October; however, no contribution was drafted for the month of December due to this errorThere is also no record on file that Mr [redacted] ’s representative ever submitted a cancellation form on his behalf back in December to support his claim, thus, Altrua had no indication that he wanted to cancel until we received a call from him directly on 01/regarding the sameAltrua did not withdrawn any further contributions as of January for his membership as a result and no other calls were received prior to this dateIt is Altrua’s policy that all cancellation forms must be received by the 15th of the month to go into effect on the first of the next monthPlease reference Section C, paragraph on page of our Membership Guidelines at https://altruahealthshare.org/resources/guidelines/ for further review of this processMr [redacted] ’s cancellation form was not received until 02/06, which will not go into effect until 03/leaving an outstanding balance to the membership for both January and February At this time, we are unable to provide Mr [redacted] with the desired resolution outlined in his complaint as Altrua has done everything according to its policies and procedures to resolve Mr [redacted] ’s issue with the information that was givenHowever, we would be willing to waive the amount owed for the months of January and February due to the miscommunication of his representativeI would suggest that Mr [redacted] reach out to the company that his representative is contracted with further report on this issueFurthermore, if Mr [redacted] has further documentation that can support his claim with Altrua we would be more than happy to reconsider this decisionWe are deeply sadden that Mr [redacted] chose to withdraw his membership due to the lack of communication and management of his representativeWe strive to improve our services every day to enhance the member experience for all of our members who choose to participate in our mission of Caring for One AnotherPlease let me know if additional information is needed to close out this complaintThank you very much for your time and patience in this matter.Warmest regards, [redacted] EXECUTIVE COMPLIANCE DIRECTOR [redacted] | www.altruahealthshare.org | P.OBox 90849, Austin, TX EMAIL DISCLAIMER LEGAL NOTICES

Below, I have copied the statement from [redacted] of the complaint she has submitted and underneath that, I have written the responseCustomers Statement of the Problem: “All bills for my husbands open heart surgery and pre-surgery procedures since April have been put on researchAltrua will not pay on any of the bills until the hospitals use their financial assistance to help usThe hospitals will not use their financial assistance until Altrua pays on the billsWe are caught in a distress situation and nothing is being done! and neither will budge an inch!” Altrua HealthShare (AHS)Response: Altrua HealthShare (AHS) is a non-profit recognized Health Care Sharing Ministry by which its members share in each other’s medical Needs according to the Guidelines that were put in place by the membersAltrua HealthShare (AHS) is NOT an insurance company and does not process medical claims as an insurance companyAltrua HealthShare (AHS) is a neutral escrow agent between members that assists with processing members medical Needs according to Member Guidelines and holds NO promise to pay any medical Need because the members remain self-payAccording to the Member Guidelines, each member is responsible for their individual medical NeedsMembers submit monthly contributions which assist other members with submitted medical Needs that are eligible for sharing according to the Member GuidelinesAltrua HealthShare (AHS) is NOT insurance and the Application for enrollment and Member Guidelines state this clearly along with the members ID card which each member submits to each provider that they individually use for their medical NeedsStatement from Mrs [redacted] :1.) “All bills for my husbands open heart surgery and pre-surgery procedures since April have been put on researchAltrua will not pay on any of the bills until the hospitals use their financial assistance to help us.” AHS Response: In the Member Guidelines, under Sharing Limits and Other Resources, it states:“Needs do not qualify for sharing to the extent that they are discountable by the provider or payable by an institutional source such as insurance, Medicare/Medicaid, VA/Champus, private grants, or by liable third partiesIf the member does not cooperate fully and assist Altrua HealthShare in determining if his/her need is discountable or payable by another party, the need will not be eligible for sharingThis limitation includes needs payable by Medicaid, if the member qualifies for MedicaidIf the member is years of age or older, this limitation also includes needs that are payable by Medicare A or B, whether the member is enrolled in Medicare or notThe MRA’s are waived up to the maximum MRA’s per membership type only if a liable third party or institutional source pays on the member’s behalfSharing of monthly contributions for a need that is later paid or found to be payable by an institutional source or a liable third party will automatically allow Altrua HealthShare full rights to recover from the member the amounts shared in their behalf.” Statement from Mrs [redacted] :2.) “The hospitals will not use their financial assistance until Altrua pays on the bills.”AHS Response:“AHS only issues payment to providers from the other members once the member with submitted medical needs has followed the member guidelinesThe financial assistance program that each hospital has in place for self-pay patients is a part of the member’s guidelines and in place for the purpose that the hospital program is designed forIt is each member’s responsibility to work with AHS and to present to medical providers the proper and correct information on how the AHS program worksAll membership ID cards state on the front that “This is NOT insurance”.” Statement from Mrs [redacted] :3.) “We are caught in a distress situation and nothing is being done! and neither will budge an inch!” AHS Response:“AHS does not desire for any member to be in a distress situation because the ministry was created to assist all families through the difficulties of dealing with medical issuesAHS is very sorry for the problem that has arisen and has every intention of continuing to work with Mrs [redacted] in following through with what the guidelines require in situations like thisIt is stated that “neither will budge an inch”, AHS is only waiting for Mrs [redacted] to be responsible for honoring the member guidelines and to follow through with her responsibility in completing the financial assistance packet as a self-pay patient so that AHS can complete its follow through.” [redacted] ’s Desired Settlement:AHS can only process member’s contributions to share in Mr [redacted] ’s medical needs once the membership guidelines has been metAHS recommends that as each member remains self-pay, that if a provider is requesting payments that the member sends the provider the payment or sets up a payment plan so that the member has the time needed to honor what the member guidelines require with the assistance programs offered by the providers In Closing:Mr& Mrs [redacted] have been members of AHS for several years and AHS’s members have shared in many thousands of dollars for medical expenses for this familyAHS is very sorry for any inconveniences that this has caused the family during this difficult time that they are dealing withAHS’s desire is that this can be resolved soon and that the [redacted] family will experience a great outcome to this issueOur prayers are with them as we pray for all members suffering with health issuesAHS will continue to follow through with the other provider’s medical charges that Mr [redacted] has received Sincerely, [redacted] Executive Director

I first want to acknowledge that we sincerely apologize for any inconveniences we may has caused Mr [redacted] due to his billing issuesOver the past couple of months, Altrua HealthShare has experienced tremendous growth that has cause some internal accounting system issues and delayed billing at times, which is what I believe Mr [redacted] has experiencedOur records indicate that he was withdrawn untimely for his voluntary monthly contribution during the month of May and June within a two week timeframe, which gave Mr [redacted] the perception that he was being double billedHowever, these payments were withdrawn to cover his membership for those monthsWe are working very diligently to fix our processes and systems to better help facilitate the grow and to better serve our membersRespectfully, we are unable to refund Mr [redacted] his contributions or this will deem him ineligible for sharing under the membershipGoing forward, we will continue to work diligently to make sure Mr [redacted] does not experience these kind of issuesWe appreciate his membership and are looking to gain back his trust for the organization as we as strive to help individuals and their families all over the world.Warmest regards, Randall LSluder, EXECUTIVE DIRECTOR| AltruaHealthShare.org | P.OBox 90849, Austin, TX

03/01/2018Revdex.comRutherford Lane Ste 100Austin, TX 78754(512) 445-4748Re: Complaint ID: [redacted] Complainant: [redacted] Attn: [redacted] Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of [redacted] as we would like to resolve this matter promptly and thank you for your patience.I first want to acknowledge Mrs [redacted] ’s frustration in trying to get her medical need reimbursement issue resolvedIt is our goal to provide all of our members with the best member service experience possible and through this response I hope she can gain peace of mind and clarity on this matter.As a guideline of Altrua’s, if a provider requires the self-pay option for medical services rendered, we require the member to obtain a self-pay discount as one of the criteria’s for the reimbursement of eligible medical needsThis is done because the membership is not given the opportunity to seek discounts through its medical needs process, which serves as a benefit to its membersPlease see Section (F) Sharing of Your Eligible Medical Needs, Paragraph on Page of our Membership Guidelines at https://altruahealthshare.org/resources/guidelines/ for further information regarding this processAlthough Mrs [redacted] did submit the required information necessary for reimbursement, it was determined during medical review that the medical need related to the reimbursement being sought was ineligible for sharing and the membership does not share in ineligible medical needs.Furthermore, medical review determined that the documentation submitted for reimbursement was part of services being treated prior to Mrs [redacted] becoming a member of Altrua and dated back to October She was enrolled on 02/1/The date of service (dos) of the medical records received were also prior to enrollment, which supported this determination as wellAny medical needs diagnosed or treated prior to becoming a member is classified as a pre-existing condition and comes with a year waiting periodIn January of 2017, Mrs [redacted] was referred to a specialist for further treatment of these services but despite medical advice chose to forego seeking the proper treatment due to a vacation she had plannedThese medical needs then turned emergent once she came back from vacation, which caused the need for her emergency surgery referenced in her complaint to occurIf Mrs [redacted] had not experienced these set of circumstances prior to being on the membership her medical needs would have still be deemed ineligible for reimbursement due to her failure to follow the proper plan of treatment against medical adviceAs a Health Care Sharing Ministry, we advocate for the well-being and care of all of our members but it is also our members responsibility to manage their care prudently and according to our guidelines.Unfortunately, we are unable to provide Mrs [redacted] with the desire resolution in her complaint due to her medical needs being ineligible for sharing as outlined by the membershipAs a current member with Altrua, I would hope Mrs [redacted] would contact us directly to resolve any further issues so that we can bring resolve to them immediatelyPlease advise if this response is sufficient to close out this complaint or contact me directly for further response.Warmest regards, [redacted] EXECUTIVE COMPLIANCE DIRECTOR [redacted] | www.altruahealthshare.org | P.OBox 90849, Austin, TX EMAIL DISCLAIMER LEGAL NOTICES

11/27/Revdex.comLa Posada DriveAustin, TX 78752(512) 445-Re: Complaint ID: *** Complainant: *** ***To Whom It May Concern: Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of Mr*** as we
are taking this complaint very seriously and would like to bring resolve to this matter promptlyIt is with great compassion that we address Mr***’s concern regarding his wife’s situation and membership with AltruaWe at Altrua value our members, their families and their health and through this response I hope they both can gain peace of mind and clarity on this matterFirst, I want to clarify that Altrua is a recognized Health Care Sharing MinistryIts membership is not insurance nor is offered through an insurance companyThe membership advocates healthy living and is intended for individuals and families that share the same set of ethical and religious beliefs who care for one another by sharing the cost of one another’s medical needs, thus, certain exclusions apply for the whole membership as outlined in our Membership GuidelinesBased on the claims received by Mr***, it is Altrua HealthShare’s policy that all medical needs relating to cancer (testing, diagnosis or otherwise) are ineligible for sharing for the first months of membership as Mr*** statedMembership Guidelines are posted on our website and received by all members upon signing up for the membership, thus, to encourage members to familiarize themselves with the eligibility of their particular membership plan typePlease refer to the link provided belowhttps://altruahealthshare.org/resources/guidelines/ Mr*** also claimed that health care providers had trouble getting in touch with us regarding preauthorization but our records indicate that these inquiries were received for those medicals needs regarding the dates provided, which as a result were determination to be ineligible for sharing based on the criterion outlined in our guidelinesWe are truly empathetic to Mr***’s wife’s situation but as a faith based organization, it would be unfair to the membership as a whole if we shared in ineligible medicals for one member and not that of the whole membershipAlthough there are no contractual promises for sharing member contributions, it’s still important to us that we are administering shared contributions as described in the Membership Guidelines, thus, members you are given the opportunity to dispute medical needs denied for sharing using our Appeals processThis process is determined by a group of Altrua peers that administer the final determinationI again sincerely wish Mr*** and his wife well but at this time we are unable to provide him with the desired settlement as outlined in his complaint and since Mr***’s wife is no longer a member we are also unable to use our Appeals process as an alternative solutionPlease let me know if additional information is needed to close out this complaintThank you very much for your time and patience in this matter

Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of *** *** as we take all complaints very seriously and would like to bring resolve to this matter promptly.We understand that Altrua may not be a perfect fit for every individuals needs and want to address Mr***’s
concern regarding his wife’s situation and membership with AltruaWe at Altrua value our members, their families and their health and through this response I hope they both can gain peace of mind and clarity on this matter.Altrua HealthShare is a recognized Health Care Sharing MinistryIts membership is not insurance nor is offered through an insurance companyThe membership does not guarantee or promise that your eligible medical needs will be shared by the membershipThis disclaimer is a requirement for all publications that govern a Health Care Sharing MinistryAltrua is recognized by the ACA for our members to be exempt from the tax penalty; however, we are not regulated by the Department of Insurance or any other regulatory agencyThus, the requirements under the ACA do not apply to our membership.Based on the claims received by Mr***, Altrua does not advertise colonoscopy as a “free preventative visit”Our Membership Guidelines specifically state that a member will be allowed one colonoscopy screening per year not to exceed threeOur records indicate that the facility mentioned in the complaint was in fact notified by our Eligibility department that these services were eligible for sharing by the membership and would go towards Mrs***’s Member Responsibility Amount (MRA), which would have been part of her out of pocket expense to the membership per her plan typeMrs*** refused to pay her out of pocket expense towards the services she was seeking due to affordability and decided not to seek services any longerWe allow our members to seek services from a provider of their choice so Mrs*** also had the opportunity to use a different provider who services were must lessA member is required to meet all Member Responsibility Amounts according to their plan type before the membership will share in the cost of eligible medical needs, which Mrs*** did not and refusedMembership Guidelines are posted on our website and received by all members upon signing up for the membership, thus, to encourage members to familiarize themselves with the eligibility of their particular membership plan typePlease refer to the following link: https://altruahealthshare.org/resources/guidelines/ Mr*** also claims that Altrua does not pay commission to agents who enroll members onto the membership; however, Altrua does not contract agents to offer their memberships nor do we contract with insurance agenciesMr***’s agent would have to contact their representative to seek the appropriate remedy for commissions owed to his agentAltrua is not responsible for the actions of a third party contractor.I sincerely wish Mr*** and his wife well but at this time we are unable to provide him with the desired resolution as outlined in his complaint as their voluntary contributions have already been submitted for member-to-member sharing and the membership has also shared in the eligible medical needs for both while on the membershipWe are more so deeply sadden that Mr*** feels that we have over promised and undelivered on the services we provide as a faith based organization and we strive to improve our services every day to enhance the member experience for all of our members who choose to participate in our mission of Caring for One Another by sharing eligible medical needsPlease let me know if additional information is needed to close out this complaintThank you very much for your time and patience in this matter.Warmest regards, *** *** EXECUTIVE ASSISTANT OF RANDALL LSLUDER, EXECUTIVE DIRECTOR

I first want to acknowledge Mrs. [redacted] frustration in trying to get her claims issue with Labcorp resolved. Thus, we are working diligently to fix all of the issues our members have been experiencing due to significant growth. However, the need Mrs. [redacted] is referring to in this complaint was...

processed and payment was issued during our 6/9 check run. This check can be reference as check #[redacted], which Labcorp should have received. Our member services representatives have been in contact with Labcorp informing them of the same. Therefore, any remaining balance of the need in question would be Mrs. [redacted] member responsibility, which has been outlined in our Membership Guidelines. If Mrs. [redacted] continues to have this same issue with Lapcorp it is our intention to help in any way we can. Please let me know if the response to both of these inquiries are sufficient to close out this case. Thank you.Warmest regards, [redacted], EXECUTIVE DIRECTOR[redacted] | AltruaHealthShare.org | P.O. Box 90849, Austin, TX 78709

03/23/2018 Revdex.com1805 Rutherford Lane Ste 100Austin, TX 78754(512) 445-4748 Re: Complaint ID: [redacted]            Complainant: [redacted]Attn: [redacted] Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of [redacted] as...

we would like to resolve this matter promptly and thank you for your patience. I first want to acknowledge Mrs. [redacted]’s frustration in trying to get her medical needs issue resolved. It is our goal to provide all of our members with the best member service experience possible and through this response I hope she can gain peace of mind and clarity on this matter. According to our records, Mrs. [redacted]’s case is in pending status with our provider resolution team. However, as a courtesy to all of our members and a way to help reduce the cost of their medical needs, Altrua passes along discounts afforded to us by our network. Unfortunately, it is not a guarantee that the provider will accept these discounts and if not our resolutions team steps in to resolve those matters. Thus, all of the medical needs Mrs. [redacted] references in her complaint is pending to get resolved as promptly as possible. Typically, this process can take anywhere from 30-90 days depending on the cooperation of all party’s involved. Please reference Section F, paragraph 2 Working with your Health Care Provider, which states a member will be responsible for 50% of the allowed charges based on the member responsibility amount under their plan type in the event her medical need is eligible. In conclusion, in order to offer a Mrs. [redacted] a resolution we will have to wait on the outcome of this case pending in the resolution dept., however, we will have a representative reach out to her directly to address her concerns regarding this compliant.   Please advise if this response is sufficient to close out this complaint or contact me directly for further response. Warmest regards,  [redacted]
EXECUTIVE COMPLIANCE DIRECTOR

I first want to acknowledge that we sincerely apologize for any inconveniences we may has caused Mr. [redacted] due to his billing issues. Over the past couple of months, Altrua HealthShare has experienced tremendous growth that has cause some internal accounting system issues and delayed billing at...

times, which is what I believe Mr. [redacted] has experienced. Our records indicate that he was withdrawn untimely for his voluntary monthly contribution during the month of May and June within a two week timeframe, which gave Mr. [redacted] the perception that he was being double billed. However, these payments were withdrawn to cover his membership for those months. We are working very diligently to fix our processes and systems to better help facilitate the grow and to better serve our members. Respectfully, we are unable to refund Mr. [redacted] his contributions or this will deem him ineligible for sharing under the membership. Going forward, we will continue to work diligently to make sure Mr. [redacted] does not experience these kind of issues. We appreciate his membership and are looking to gain back his trust for the organization as we as strive to help individuals and their families all over the world.Warmest regards, Randall L. Sluder, EXECUTIVE DIRECTOR1 888.244.3839 | AltruaHealthShare.org | P.O. Box 90849, Austin, TX 78709

Below, I have copied the statement from [redacted] of the complaint she has submitted and underneath that, I have written the response. Customers Statement of the Problem: “All bills for my husbands open heart surgery and pre-surgery procedures since April 2015 have...

been put on research. Altrua will not pay on any of the bills until the hospitals use their financial assistance to help us. The hospitals will not use their financial assistance until Altrua pays on the bills. We are caught in a distress situation and nothing is being done! and neither will budge an inch!”  Altrua HealthShare (AHS)Response: Altrua HealthShare (AHS) is a non-profit recognized Health Care Sharing Ministry by which its members share in each other’s medical Needs according to the Guidelines that were put in place by the members. Altrua HealthShare (AHS) is NOT an insurance company and does not process medical claims as an insurance company. Altrua HealthShare (AHS) is a neutral escrow agent between members that assists with processing members medical Needs according to Member Guidelines and holds NO promise to pay any medical Need because the members remain self-pay. According to the Member Guidelines, each member is responsible for their individual medical Needs. Members submit monthly contributions which assist other members with submitted medical Needs that are eligible for sharing according to the Member Guidelines. Altrua HealthShare (AHS) is NOT insurance and the Application for enrollment and Member Guidelines state this clearly along with the members ID card which each member submits to each provider that they individually use for their medical Needs. Statement from Mrs. [redacted]:1.)    “All bills for my husbands open heart surgery and pre-surgery procedures since April 2015 have been put on research. Altrua will not pay on any of the bills until the hospitals use their financial assistance to help us.” AHS Response: In the Member Guidelines, under Sharing Limits and Other Resources, it states:“Needs do not qualify for sharing to the extent that they are discountable by the provider or payable by an institutional source such as insurance, Medicare/Medicaid, VA/Champus, private grants, or by liable third parties. If the member does not cooperate fully and assist Altrua HealthShare in determining if his/her need is discountable or payable by another party, the need will not be eligible for sharing. This limitation includes needs payable by Medicaid, if the member qualifies for Medicaid. If the member is 65 years of age or older, this limitation also includes needs that are payable by Medicare A or B, whether the member is enrolled in Medicare or not. The MRA’s are waived up to the maximum MRA’s per membership type only if a liable third party or institutional source pays on the member’s behalf. Sharing of monthly contributions for a need that is later paid or found to be payable by an institutional source or a liable third party will automatically allow Altrua HealthShare full rights to recover from the member the amounts shared in their behalf.” Statement from Mrs. [redacted]:2.)    “The hospitals will not use their financial assistance until Altrua pays on the bills.”AHS Response:“AHS only issues payment to providers from the other members once the member with submitted medical needs has followed the member guidelines. The financial assistance program that each hospital has in place for self-pay patients is a part of the member’s guidelines and in place for the purpose that the hospital program is designed for. It is each member’s responsibility to work with AHS and to present to medical providers the proper and correct information on how the AHS program works. All membership ID cards state on the front that “This is NOT insurance”.” Statement from Mrs. [redacted]:3.)    “We are caught in a distress situation and nothing is being done! and neither will budge an inch!” AHS Response:“AHS does not desire for any member to be in a distress situation because the ministry was created to assist all families through the difficulties of dealing with medical issues. AHS is very sorry for the problem that has arisen and has every intention of continuing to work with Mrs. [redacted] in following through with what the guidelines require in situations like this. It is stated that “neither will budge an inch”, AHS is only waiting for Mrs. [redacted] to be responsible for honoring the member guidelines and to follow through with her responsibility in completing the financial assistance packet as a self-pay patient so that AHS can complete its follow through.”  [redacted]’s Desired Settlement:AHS can only process member’s contributions to share in Mr. [redacted]’s medical needs once the membership guidelines has been met. AHS recommends that as each member remains self-pay, that if a provider is requesting payments that the member sends the provider the payment or sets up a payment plan so that the member has the time needed to honor what the member guidelines require with the assistance programs offered by the providers.  In Closing:Mr. & Mrs. [redacted] have been members of AHS for several years and AHS’s members have shared in many thousands of dollars for medical expenses for this family. AHS is very sorry for any inconveniences that this has caused the family during this difficult time that they are dealing with. AHS’s desire is that this can be resolved soon and that the [redacted] family will experience a great outcome to this issue. Our prayers are with them as we pray for all members suffering with health issues. AHS will continue to follow through with the other provider’s medical charges that Mr. [redacted] has received.  Sincerely, [redacted]Executive Director

03/01/2018Revdex.com1805 Rutherford Lane Ste 100Austin, TX 78754(512) 445-4748Re: Complaint ID: [redacted]            Complainant: [redacted]Attn: [redacted]Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of [redacted] as we would like to...

resolve this matter promptly and thank you for your patience.I first want to acknowledge Mrs. [redacted]’s frustration in trying to get her medical need reimbursement issue resolved. It is our goal to provide all of our members with the best member service experience possible and through this response I hope she can gain peace of mind and clarity on this matter.As a guideline of Altrua’s, if a provider requires the self-pay option for medical services rendered, we require the member to obtain a self-pay discount as one of the criteria’s for the reimbursement of eligible medical needs. This is done because the membership is not given the opportunity to seek discounts through its normal medical needs process, which serves as a benefit to its members. Please see Section (F) Sharing of Your Eligible Medical Needs, Paragraph 3 on Page 17 of our 2018 Membership Guidelines at https://altruahealthshare.org/resources/guidelines/ for further information regarding this process. Although Mrs. [redacted] did submit the required information necessary for reimbursement, it was determined during medical review that the medical need related to the reimbursement being sought was ineligible for sharing and the membership does not share in ineligible medical needs.Furthermore, medical review determined that the documentation submitted for reimbursement was part of services being treated prior to Mrs. [redacted] becoming a member of Altrua and dated back to October 2016. She was enrolled on 02/1/17. The date of service (dos) of the medical records received were also prior to enrollment, which supported this determination as well. Any medical needs diagnosed or treated prior to becoming a member is classified as a pre-existing condition and comes with a 2 year waiting period. In January of 2017, Mrs. [redacted] was referred to a specialist for further treatment of these services but despite medical advice chose to forego seeking the proper treatment due to a vacation she had planned. These medical needs then turned emergent once she came back from vacation, which caused the need for her emergency surgery referenced in her complaint to occur. If Mrs. [redacted] had not experienced these set of circumstances prior to being on the membership her medical needs would have still be deemed ineligible for reimbursement due to her failure to follow the proper plan of treatment against medical advice. As a Health Care Sharing Ministry, we advocate for the well-being and care of all of our members but it is also our members responsibility to manage their care prudently and according to our guidelines.Unfortunately, we are unable to provide Mrs. [redacted] with the desire resolution in her complaint due to her medical needs being ineligible for sharing as outlined by the membership. As a current member with Altrua, I would hope Mrs. [redacted] would contact us directly to resolve any further issues so that we can bring resolve to them immediately. Please advise if this response is sufficient to close out this complaint or contact me directly for further response.Warmest regards, [redacted]
EXECUTIVE COMPLIANCE DIRECTOR[redacted] | www.altruahealthshare.org | P.O. Box 90849, Austin, TX 78709 EMAIL DISCLAIMER LEGAL NOTICES

03/01/2018Revdex.com1805 Rutherford Lane Ste 100Austin, TX 78754(512) 445-4748Re: Complaint ID: [redacted]            Complainant: [redacted]ATTN: [redacted]Thank you for reaching out to Altrua HealthShare (“Altrua”) on behalf of [redacted] and thank you for...

your patience in receiving this response. It is our responsibility to take all complaints very seriously and it is our every intention to bring resolve to these matters promptly.I first want to acknowledge that we sincerely apologize for any inconvenience Mr. [redacted] may have experienced due to billing issues. Thus, we value our members experience with Altrua and strive every day to improve the services being provided.As a member of Altrua, it is the member’s responsibility to contact us directly if they are having any issues regarding their membership. This is outlined in the Members Rights and Responsibilities section of our Membership Guidelines. Every year Altrua conducts a year end audit for all contributions received on behalf of the membership. This audit produced a list of members that did not contribute to the membership during specific months based on their individual accounts. As a good faith measure, all members were informed of any contributions that were not received for their particular account. However, this notification also included that, if for any reason, our records were incorrect to contact us directly to resolve this issue promptly. Altrua does not contract with agents to offer their memberships nor do we contract with insurance agencies. Thus, Altrua is not responsible for the actions of a third party that a member willful chooses to manage their membership. Our records indicate that Mr. [redacted]’s proof of overpayment was not received until 02/05/2018, which did indicate he was billed twice in the month of October; however, no contribution was drafted for the month of December due to this error. There is also no record on file that Mr. [redacted]’s representative ever submitted a cancellation form on his behalf back in December to support his claim, thus, Altrua had no indication that he wanted to cancel until we received a call from him directly on 01/05 regarding the same. Altrua did not withdrawn any further contributions as of January for his membership as a result and no other calls were received prior to this date. It is Altrua’s policy that all cancellation forms must be received by the 15th of the month to go into effect on the first of the next month. Please reference Section C, paragraph 4 on page 4 of our 2017 Membership Guidelines at https://altruahealthshare.org/resources/guidelines/ for further review of this process. Mr. [redacted]’s cancellation form was not received until 02/06, which will not go into effect until 03/01 leaving an outstanding balance to the membership for both January and February.  At this time, we are unable to provide Mr. [redacted] with the desired resolution outlined in his complaint as Altrua has done everything according to its policies and procedures to resolve Mr. [redacted]’s issue with the information that was given. However, we would be willing to waive the amount owed for the months of January and February due to the miscommunication of his representative. I would suggest that Mr. [redacted] reach out to the company that his representative is contracted with further report on this issue. Furthermore, if Mr. [redacted] has further documentation that can support his claim with Altrua we would be more than happy to reconsider this decision. We are deeply sadden that Mr. [redacted] chose to withdraw his membership due to the lack of communication and management of his representative. We strive to improve our services every day to enhance the member experience for all of our members who choose to participate in our mission of Caring for One Another. Please let me know if additional information is needed to close out this complaint. Thank you very much for your time and patience in this matter.Warmest regards, [redacted]
EXECUTIVE COMPLIANCE DIRECTOR
[redacted] | www.altruahealthshare.org | P.O. Box 90849, Austin, TX 78709 EMAIL DISCLAIMER LEGAL NOTICES

I had Altrua for years and got great service until 2015. I had a hysterectomy and Altrua was horrible in processing it and some other submissions....their excuses were lame and caused me a lot of financial hardship.

Previous to my hysterectomy, I broke both of my wrists exercising and Altrua Healthshare only paid $5000. If an individual has any complications from extracurricular activities such as playing in a band, playing badminton, exercising...there is a $5000 cap.

My daughter has been on Altura's Silver plan for 2 years and failed to complete some paperwork last November. Altrua insists on direct draw from an individual's checking account so my daughter didn't catch this until a few days ago due to money missing from their tight checking account. Altrua increased her "CONTRIBUTION" from $215/month to $672.00!!!! They refuse to refund the excess money they stole stating it was a contribution and it was already "too far"into the month.

Altrua is cheap....and you definitely get what you pay for...its really sad.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sir With reference to the above complaint. The matter has now been resolved therefore no action on your part is...

necessary. Kindest regards[redacted]

Complaint: [redacted]
I am rejecting this response because:it is true that altrua staff was calling Labcorp but most often only after I requested it. I continued to receive overdue notices through 8/7/17 from Labcorp and I had already paid them my healthshare amount of $24.68. When I called Labcorp last on 8/24/17 they said the balance was still outstanding. What Altrua doesn't tell you is that once a claim is processed, as in this case on 6/9 per the company's response to my complaint, it does not mean that the check is mailed in a timely manner! It goes to an audit process after that which in several claims for us this year have taken months. This complaint is only one instance of three that we have had trouble with and our PCP will no longer file for us with Altrua because he didn't get paid for a January office visit until June!
Regards,
[redacted]

Below, I have copied the statement from [redacted] of the complaint she has submitted and underneath that, I have written the response. Customers Statement of the Problem: “All bills for my husbands open heart surgery and pre-surgery procedures since April 2015 have been put on...

research. Altrua will not pay on any of the bills until the hospitals use their financial assistance to help us. The hospitals will not use their financial assistance until Altrua pays on the bills. We are caught in a distress situation and nothing is being done! and neither will budge an inch!”  Altrua HealthShare (AHS)Response: Altrua HealthShare (AHS) is a non-profit recognized Health Care Sharing Ministry by which its members share in each other’s medical Needs according to the Guidelines that were put in place by the members. Altrua HealthShare (AHS) is NOT an insurance company and does not process medical claims as an insurance company. Altrua HealthShare (AHS) is a neutral escrow agent between members that assists with processing members medical Needs according to Member Guidelines and holds NO promise to pay any medical Need because the members remain self-pay. According to the Member Guidelines, each member is responsible for their individual medical Needs. Members submit monthly contributions which assist other members with submitted medical Needs that are eligible for sharing according to the Member Guidelines. Altrua HealthShare (AHS) is NOT insurance and the Application for enrollment and Member Guidelines state this clearly along with the members ID card which each member submits to each provider that they individually use for their medical Needs. Statement from Mrs. [redacted]:1.)    “All bills for my husbands open heart surgery and pre-surgery procedures since April 2015 have been put on research. Altrua will not pay on any of the bills until the hospitals use their financial assistance to help us.” AHS Response: In the Member Guidelines, under Sharing Limits and Other Resources, it states:“Needs do not qualify for sharing to the extent that they are discountable by the provider or payable by an institutional source such as insurance, Medicare/Medicaid, VA/Champus, private grants, or by liable third parties. If the member does not cooperate fully and assist Altrua HealthShare in determining if his/her need is discountable or payable by another party, the need will not be eligible for sharing. This limitation includes needs payable by Medicaid, if the member qualifies for Medicaid. If the member is 65 years of age or older, this limitation also includes needs that are payable by Medicare A or B, whether the member is enrolled in Medicare or not. The MRA’s are waived up to the maximum MRA’s per membership type only if a liable third party or institutional source pays on the member’s behalf. Sharing of monthly contributions for a need that is later paid or found to be payable by an institutional source or a liable third party will automatically allow Altrua HealthShare full rights to recover from the member the amounts shared in their behalf.” Statement from Mrs. [redacted]:2.)    “The hospitals will not use their financial assistance until Altrua pays on the bills.”AHS Response:“AHS only issues payment to providers from the other members once the member with submitted medical needs has followed the member guidelines. The financial assistance program that each hospital has in place for self-pay patients is a part of the member’s guidelines and in place for the purpose that the hospital program is designed for. It is each member’s responsibility to work with AHS and to present to medical providers the proper and correct information on how the AHS program works. All membership ID cards state on the front that “This is NOT insurance”.” Statement from Mrs. [redacted]:3.)    “We are caught in a distress situation and nothing is being done! and neither will budge an inch!” AHS Response:“AHS does not desire for any member to be in a distress situation because the ministry was created to assist all families through the difficulties of dealing with medical issues. AHS is very sorry for the problem that has arisen and has every intention of continuing to work with Mrs. [redacted] in following through with what the guidelines require in situations like this. It is stated that “neither will budge an inch”, AHS is only waiting for Mrs. [redacted] to be responsible for honoring the member guidelines and to follow through with her responsibility in completing the financial assistance packet as a self-pay patient so that AHS can complete its follow through.”  [redacted]’s Desired Settlement:AHS can only process member’s contributions to share in Mr. [redacted]’s medical needs once the membership guidelines has been met. AHS recommends that as each member remains self-pay, that if a provider is requesting payments that the member sends the provider the payment or sets up a payment plan so that the member has the time needed to honor what the member guidelines require with the assistance programs offered by the providers.  In Closing:Mr. & Mrs. [redacted] have been members of AHS for several years and AHS’s members have shared in many thousands of dollars for medical expenses for this family. AHS is very sorry for any inconveniences that this has caused the family during this difficult time that they are dealing with. AHS’s desire is that this can be resolved soon and that the [redacted] family will experience a great outcome to this issue. Our prayers are with them as we pray for all members suffering with health issues. AHS will continue to follow through with the other provider’s medical charges that Mr. [redacted] has received.  Sincerely, [redacted]Executive Director